TY - JOUR
T1 - Epidemiology, Prehospital Characteristics and Outcomes of Severe Traumatic Brain Injury in The Netherlands
T2 - The BRAIN-PROTECT Study
AU - on behalf of the BRAIN-PROTECT collaborators
AU - Bossers, Sebastiaan M.
AU - Boer, Christa
AU - Bloemers, Frank W.
AU - van Lieshout, Esther M. M.
AU - den Hartog, Dennis
AU - Hoogerwerf, Nico
AU - Innemee, Gerard
AU - van der Naalt, Joukje
AU - Absalom, Anthony R.
AU - Peerdeman, Saskia M.
AU - de Visser, Matthijs
AU - de Leeuw, Marcel A.
AU - Schwarte, Lothar A.
AU - Loer, Stephan A.
AU - Schober, Patrick
PY - 2021
Y1 - 2021
N2 - Objective: A thorough understanding of the epidemiology, patient characteristics, trauma mechanisms, and current outcomes among patients with severe traumatic brain injury (TBI) is important as it may inform potential strategies to improve prehospital emergency care. The aim of this study is to describe the prehospital epidemiology, characteristics and outcome of (suspected) severe TBI in the Netherlands. Methods: The BRAIN-PROTECT study is a prospective observational study on prehospital management of patients with severe TBI in the Netherlands. The study population comprised all consecutive patients with clinical suspicion of TBI and a prehospital GCS score ≤ 8, who were managed by one of the 4 Helicopter Emergency Medical Services (HEMS). Patients were followed-up in 9 trauma centers until 1 year after injury. Planned sub-analyses were performed for patients with “confirmed” and “isolated” TBI. Results: Data from 2,589 patients, of whom 2,117 (81.8%) were transferred to a participating trauma center, were analyzed. The incidence rate of prehospitally suspected and confirmed severe TBI were 3.2 (95% CI: 3.1;3.4) and 2.7 (95% CI: 2.5;2.8) per 100,000 inhabitants per year, respectively. Median patient age was 46 years, 58.4% were involved in traffic crashes, of which 37.4% were bicycle related. 47.6% presented with an initial GCS of 3. The median time from HEMS dispatch to hospital arrival was 54 minutes. The overall 30-day mortality was 39.0% (95% CI: 36.8;41.2). Conclusion: This article summarizes the prehospital epidemiology, characteristics and outcome of severe TBI in the Netherlands, and highlights areas in which primary prevention and prehospital care can be improved.
AB - Objective: A thorough understanding of the epidemiology, patient characteristics, trauma mechanisms, and current outcomes among patients with severe traumatic brain injury (TBI) is important as it may inform potential strategies to improve prehospital emergency care. The aim of this study is to describe the prehospital epidemiology, characteristics and outcome of (suspected) severe TBI in the Netherlands. Methods: The BRAIN-PROTECT study is a prospective observational study on prehospital management of patients with severe TBI in the Netherlands. The study population comprised all consecutive patients with clinical suspicion of TBI and a prehospital GCS score ≤ 8, who were managed by one of the 4 Helicopter Emergency Medical Services (HEMS). Patients were followed-up in 9 trauma centers until 1 year after injury. Planned sub-analyses were performed for patients with “confirmed” and “isolated” TBI. Results: Data from 2,589 patients, of whom 2,117 (81.8%) were transferred to a participating trauma center, were analyzed. The incidence rate of prehospitally suspected and confirmed severe TBI were 3.2 (95% CI: 3.1;3.4) and 2.7 (95% CI: 2.5;2.8) per 100,000 inhabitants per year, respectively. Median patient age was 46 years, 58.4% were involved in traffic crashes, of which 37.4% were bicycle related. 47.6% presented with an initial GCS of 3. The median time from HEMS dispatch to hospital arrival was 54 minutes. The overall 30-day mortality was 39.0% (95% CI: 36.8;41.2). Conclusion: This article summarizes the prehospital epidemiology, characteristics and outcome of severe TBI in the Netherlands, and highlights areas in which primary prevention and prehospital care can be improved.
KW - air ambulances
KW - brain injuries
KW - characteristics
KW - emergency medical services
KW - epidemiology
KW - incidence rate
KW - traumatic
KW - treatment outcome
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85095735262&origin=inward
UR - https://www.ncbi.nlm.nih.gov/pubmed/32960672
UR - http://www.scopus.com/inward/record.url?scp=85095735262&partnerID=8YFLogxK
U2 - https://doi.org/10.1080/10903127.2020.1824049
DO - https://doi.org/10.1080/10903127.2020.1824049
M3 - Article
C2 - 32960672
SN - 1090-3127
VL - 25
SP - 644
EP - 655
JO - Prehospital emergency care
JF - Prehospital emergency care
IS - 5
M1 - 107442
ER -